Nursing Elites

1. A nurse is providing teaching to a client who has a urinary tract infection and new prescriptions for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching?

• A. If the phenazopyridine upsets my stomach, I can take it with meals.
• B. The phenazopyridine will relieve my discomfort, but the ciprofloxacin will get rid of the infection.
• C. I need to drink 2 liters of fluid per day while I am taking the ciprofloxacin.
• D. I should notify my provider immediately if my urine turns an orange color.

Correct answer: D

Rationale: Phenazopyridine can turn the urine orange, which is a normal side effect and not a cause for alarm. The client's statement about notifying the provider immediately if their urine turns orange indicates a need for further teaching because it shows a misunderstanding of the medication's side effects. Choices A, B, and C demonstrate a good understanding of the prescribed medications and their effects, indicating the client has grasped the teaching provided on those aspects.

2. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following indicates she is dehydrated?

• A. Urine specific gravity of 1.035
• B. Oliguria
• C. Increased urine concentration
• D. Dry mucous membranes

Correct answer: A

Rationale: The correct answer is A: Urine specific gravity of 1.035. A urine specific gravity greater than 1.030 indicates dehydration as the kidneys conserve water in response to dehydration. Choice B, oliguria, refers to decreased urine output, which can be a sign of dehydration but is not specific to it. Choice C, increased urine concentration, is a general term and does not directly indicate dehydration. Choice D, dry mucous membranes, can be a sign of dehydration but is not as specific as a urine specific gravity greater than 1.030.

3. A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication?

• A. Hyperthyroidism
• B. Intestinal obstruction
• C. Glaucoma
• D. Low blood pressure

Correct answer: B

Rationale: The correct answer is B: Intestinal obstruction. Metoclopramide is contraindicated in clients with intestinal obstruction due to its prokinetic effects, which could exacerbate the condition. Choices A, C, and D are incorrect because metoclopramide is not contraindicated in hyperthyroidism, glaucoma, or low blood pressure. Hyperthyroidism, glaucoma, and low blood pressure are not specific contraindications for metoclopramide use, and this medication is commonly prescribed for conditions like gastroesophageal reflux disease and diabetic gastroparesis.

4. A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects?

• A. Hyperkalemia
• B. Hypertension
• C. Constipation
• D. Nephrotoxicity

Correct answer: D

Rationale: Correct. Amphotericin B is known for its nephrotoxicity, which can lead to kidney damage. Monitoring kidney function is crucial to detect any signs of nephrotoxicity early. Choices A, B, and C are incorrect because hyperkalemia, hypertension, and constipation are not typically associated with amphotericin B use. Therefore, the nurse should focus on monitoring for nephrotoxicity.

5. A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests?

• A. Platelet count
• B. Electrolyte levels
• C. Thyroid function
• D. Liver function

Correct answer: D

Rationale: The correct answer is D: Liver function. Gemfibrozil can lead to hepatotoxicity, making it crucial to monitor liver function tests. Monitoring platelet count (choice A) is not specifically indicated for gemfibrozil. Electrolyte levels (choice B) and thyroid function (choice C) are not directly affected by gemfibrozil, so they are not the primary laboratory tests to monitor in this case.

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